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Withdrawal Form - South Lyon Community School
Please complete this withdrawal form if your child will no longer be attending SLCS.
Please inform your child's school office that your child will be leaving and that you have completed this form.
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* Indicates required question
Student's Last Name
*
Your answer
Student's First Name
*
Your answer
Grade
*
Your answer
Last date student will be in class
*
MM
/
DD
/
YYYY
Student's School
*
Choose
Bartlett
Brummer
Dolsen
Hardy
Kent Lake
Pearson
Salem
Sayre
Centennial
Millennium
South Lyon High School
South Lyon East High School
Early Childhood Center
Does your child receive Special Education services?
*
Yes
No
Parent's Last Name
*
Your answer
Parent's First Name
*
Your answer
Parent's Phone Number
*
Your answer
Parent's Email Address
*
Your answer
Name of New School
*
Your answer
Name of New District
Your answer
If you will be homeschooling and utilizing a specific program, what is the name of the program?
Please note that If you select to homeschool, you as a family are responsible for all materials.
Your answer
Chromebooks/Technology Device Return
*
School issued Chromebooks or any other technology devices
must
to be returned to the school. Per the District
Technology agreement
, failure to return the device is subject to reimbursement of the cost of the device by Parent/Student. Please select one of the following options.
Chromebook or other technology device will be returned to the school
Chromebook or other technology device not returned, will pay reimbursement
My student has not been issued a district technology device
Other (Contact your school principal)
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